John G. Neihardt Foundation Membership Application
402-648-3388 * 1-888-777-4667 * Bancroft, Nebraska 68004
(Please check appropriate box)
| $25.00 For Individual Annual Membership | $30.00 For Couple or Family Annual Membership | $500.00 Life Membership paid at rate of $100 per year | $_______ Contribution |
Name _______________________________________________________________________
Address ________________________________________ P.O. Box No. _________________
City _____________________________________ State _____________ Zip _____________
| Mail to: JOHN G. NEIHARDT FOUNDATION, INC
P.O. BOX 344 BANCROFT, NE 68004-0126 |
Thank you! |